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目的:研究中药二黄散对伴有HPV感染的CINⅠ患者对宫颈局部免疫状态的影响。方法:选取伴有HPV感染的CINⅠ患者60例进行中药二黄散治疗,并观察治疗效果,同时用ELISA方法测定阴道灌洗液辅助性T淋巴细胞(Th细胞)1、2细胞因子水平,免疫组织化学方法检测中药二黄散治疗前后宫颈组织T-bet、GATA3表达,同时结合临床资料进行分析。结果:CINⅠ和HPV治疗结束后3个月转归率分别为76.7%、51.7%,患者治疗后IL-2、IL-4、IL-10水平,与治疗前比较,差异均无统计学意义(P>0.05);但治疗后IFN-γ水平均明显升高,与治疗前比较,差异有统计学意义(P<0.01);且治疗后宫颈组织T-bet蛋白表达升高(P<0.01),GATA3蛋白表达降低(P<0.05)。T-bet/GATA3比值较治疗前显著升高(P<0.01)。结论:中药二黄散对伴有HPV感染的CINⅠ患者有较好的治疗作用,其治疗机制可能为:上调T-bet蛋白的表达,增强Th1细胞因子IFN-γ,相应地使Th2/Th1平衡向Th1偏移从而发挥抗HPV作用及治疗宫颈病变的作用。
Objective: To study the effect of Chinese medicine Erhuang powder on cervical local immune status in patients with CIN Ⅰ associated with HPV infection. Methods: Sixty patients with CIN Ⅰ associated with HPV infection were treated with Erhuang San and the therapeutic effect was observed. ELISA was also used to determine the levels of cytokines and cytokines in T helper lymphocytes (Th cells) of vaginal lavage fluid Tissue chemistry was used to detect the expression of T-bet and GATA3 in cervical tissue before and after treatment with Erhuang San. Meanwhile, the clinical data were analyzed. Results: The outcomes of CIN I and HPV after 3 months of treatment were 76.7% and 51.7% respectively. There was no significant difference in the levels of IL-2, IL-4 and IL-10 between the two groups after treatment (P <0.01). After treatment, the expression of T-bet protein in cervical tissue increased (P <0.01) , GATA3 protein expression decreased (P <0.05). T-bet / GATA3 ratio was significantly higher than before treatment (P <0.01). CONCLUSION: Chinese medicine Erhuang San has better therapeutic effect on patients with CIN Ⅰ associated with HPV infection. Its therapeutic mechanism may be as follows: up-regulating the expression of T-bet, enhancing Th1 cytokine IFN-γ, and correspondingly balancing Th2 / Th1 To Th1 shift in order to play an anti-HPV effect and the role of treatment of cervical lesions.